Factors affecting African-American participation in AIDS research

Background: Although African Americans are disproportionately affected by t he AIDS epidemic, they are underrepresented in AIDS research, particularly in AIDS clinical trials. This study examines a multidimensional construct o f distrust and other factors that may affect willingness to participate in AIDS research. Methods: A total of 301 African Americans (aged greater than or equal to 18 years) in Durham, North Carolina participated in a cross-sectional survey. In-person interviews, 20 to 25 minutes in length, were conducted with part icipants. Structural equation modeling was used to develop models exploring distrust and other factors affecting willingness to participate in AIDS re search among African Americans. Results: Distrust was the strongest inverse predictor of willingness to par ticipate in AIDS clinical trials. Distrust was not significantly associated with willingness to participate in AIDS surveys and educational interventi ons. Altruism, facilitators/barriers, religiosity, and economic group membe rship were also significantly associated with willingness to participate in AIDS clinical trials. Only altruism was significantly associated with will ingness to participate in AIDS surveys and educational interventions. Conclusions: Distrust about research institutions is a significant barrier to recruiting African Americans in AIDS clinical trials. Issues of distrust need to be acknowledged by researchers to develop better recruitment and r etention strategies when conducting AIDS clinical trials in African-America n communities.